Respiratory PHYSIology

Question 1

what structures are in the conducting zone?

Answer 1

larynx
trachea
primary bronchi
secondary bronchi
tertiary bronchi
small bronchi
bronchioles
terminal bronchioles

Question 2

what structures are in the respiratory zone?

Answer 2

respiratory bronchioles
alveoli

Question 3

T/F: the structures within the bronchial tree function independently of each other

Answer 3

T

Question 4

which bronchi is straighter/more vertical & shorter and implicated more in diseases & choking

Answer 4

Right bronchi

Question 5

at what division is bronchitis or other infections more likely to happen?

Answer 5

17-19 respiratory bronchiole

Question 6

which zones are conducting zones? why are they called this?

Answer 6

zones 1-16
there is no gas exchange = dead space

Question 7

the process of gas exchange occurs through ____

Answer 7

diffusion

Question 8

is diffusion more sensitive to O2 or CO2

Answer 8

CO2!!!

Question 9

what causes more of a trigger to breath?

Answer 9

high CO2 rather than low O2

Question 10

CO2 diffusion occurs ____ times faster than O2

Answer 10

4 times

Question 11

COPD patients are _____capnic

Answer 11

HYPER

Question 12

Muscles produce pressure gradient in thoracic cage that is _____ than atmospheric

Answer 12

lower

Question 13

the pressure in the interpleural space is ____ than the atmospheric pressure to keep the lung inflated

Answer 13

lower

Question 14

which side of the diaphragm sits higher?

Answer 14

Right (d/t liver)

Question 14

when a person inhales, the pressure in the lungs ____

Answer 14

increases

Question 14

how does weakness in the ribs and/or diaphragm make it harder to breath?

Answer 14

can’t create negative pressure in pulmonic space –> work harder to breathe

Question 15

what is minute ventilation?

Answer 15

Volume of air that is breathed in and out in 1 min

Tidal volume x RR

Question 16

which is better to ventilate the alveoli:
a) higher tidal volume with lower RR
b) lower tidal volume with higher RR

Answer 16

a

Question 17

where does blood go through vessels slower?

Answer 17

at the capillaries

Question 18

how does the Valsalva maneuver decrease perfusion?

Answer 18

Causes decreased venous return and more blood pumped out

Question 20

what is surfactant?

Answer 20

fluid to keep lungs open (prevent collapse)

decreased –> SIDS, burns, acute respiratory distress

Question 21

intrapleural pressure should be

Answer 21

negative

Question 22

if intra-alveolar pressure is decreased, the volume of air ____ (increases/decreases) and air goes _____ (closer/farther)

Answer 22

increases
farther

Question 23

what creates the pressure gradient in the lungs?

Answer 23

muscle groups

Question 24

when a person exhales, pressure ______ (increases/decreases)

Answer 24

increases

Question 25

what can cause the diaphragm to migrate upwards?

Answer 25

supine position obesity decreased tone

Question 26

after pulmonary surgery, is reduced which cause exhalation to be harder

Answer 26

Function Residual Capacity (FRC)

Question 27

what is Function Residual Capacity (FRC)?

Answer 27

Ability to exhale beyond normal and still have air in the lungs ER + RV = FRC

Question 28

Exhalation is ____; inhalation is ____ (passive/active)

Answer 28

passive active

Question 29

increased compliance or a lung that is too stretch out leads to what type of disease?

Answer 29

obstructive (too much O2 left in lungs)

Question 30

decreased compliance leads to what type of disease?

Answer 30

restrictive

Question 31

there is a higher ____ pressure gradient in restrictive lung diseases

Answer 31

positive

Question 32

what is expiratory reserve?

Answer 32

Amount of air can force out after normal exhale

Question 32

what is residual volume?

Answer 32

Air left in lungs after maximal exhale

Question 33

obstructive diseases have a/an _____ residual volume (increased/decreased)

Answer 33

increased

Question 34

restrictive diseases have a/an _____ residual volume (increased/decreased)

Answer 34

decreased

Question 35

which type of lung disease has a decreased tidal volume?

Answer 35

restrictive

Question 36

what is vital capacity?

Answer 36

inspiratory capacity + expiratory reserve volume + tidal volume how much can maximally inhale and exhale

Question 37

total lung capacity _____ (increases/decreases) with COPD

Answer 37

increases

Question 38

total lung capacity _____ (increases/decreases) with restrictive diseases

Answer 38

decreases

Question 39

T/F: residual volume, functional residual capacity, and total lung capacity can be determined with basic spirometry

Answer 39

F (calculated mathematically)

Question 40

what is a normal FEV 1?

Answer 40

80%

Question 41

an FEV 1 of <80% indicates a ____ disease

Answer 41

obstructive

Question 42

FEV 1 is estimated based on

Answer 42

Age, gender, race, height

Question 43

what is a normal FEV1/FVC = forced vital capacity?

Answer 43

70% (<70% = COPD)

Question 44

should inhalation or exhalation be focused on with restrictive disorder patients?

Answer 44

inhalation

Question 45

should inhalation or exhalation be focused on with obstructive disorder patients?

Answer 45

exhalation

Question 46

why does exhalation take longer is obstructive diseases?

Answer 46

decreased elasticity

Question 47

what is a normal ventilation-perfusion ratio?

Answer 47

0.8 (ideal = 1)

Question 48

what occurs if there is more perfusion than ventilation?

Answer 48

shunting (occurs in pneumonia, COPD, asthma)

Question 49

what occurs if there is less perfusion than ventilation?

Answer 49

dead space

Question 50

where is there more perfusion in an upright position?

Answer 50

bases

Question 51

relatively, there is more perfusion in the ____ part of the lungs and more ventilation at the ______ parts

Answer 51

more perfusion - bases more ventilation - upper & middle

Question 52

what position is gravity reduced for the diaphragm?

Answer 52

prone

Question 53

how does the ventilation/perfusion ratio change during exercise?

Answer 53

the upper lobes become more perfused and VPR is closer to 1

Question 54

which type of diseases have diffusion issues?

Answer 54

restrictive (space between alveoli and capillaries are increased)

Question 55

diffusion is maintained by

Answer 55

- slow blood at capillaries - thin membrane b/w capillaries and alveoli - capillaries are close to RBC size

Question 56

what occurs in bronchopulmonary dysplasia?

Answer 56

Bronchial tree more fibrotic Increased distance b/w alveoli and capillaries

Question 57

there is mass vaso____ through pulmonary system with pulmonary HTN

Answer 57

vasoconstriction

Question 58

how is pulmonary HTN monitored?

Answer 58

with a Swan Ganz catheter (R heart cath)

Question 59

what pulmonary pressure is too high during exercise?

Answer 59

>40 mm Hg

Question 60

what pulmonary pressure is indicative of pulmonary HTN?

Answer 60

>20 mm Hg at rest

Question 61

what is the #1 reason for ventilation perfusion mismatch?

Answer 61

hypoxemia

Question 62

what is the only situation in which supplemental O2 will not help?

Answer 62

large intrapulmonary shunt (large pulmonary embolism)

Question 63

Most CO2 is transported as

Answer 63

bicarbonate

Question 64

ways in which CO2 in transported in the blood

Answer 64

bicarbonate (mostly) bound to Hb (5%) in plasma (5%)

Question 65

how does breathing change with metabolic acidosis?

Answer 65

Kussmaul's respirations: rapid and deep breaths

Question 67

how is O2 mainly transported?

Answer 67

bound to Hb

Question 68

what are the controls of respiration?

Answer 68

- chemoreceptors in medulla - motor cortex, cerebellum, reticular formation - carotid bodies - skeletal muscles mechanoreceptors - more air in the lungs causing stretch (increase RR) - temperature (higher = inc RR)

Question 69

how does a rebreather mask help with respiration?

Answer 69

the inspired CO2 stimulates inhales - increases RR

Question 70

what is a normal blood pH?

Answer 70

7.4

Question 71

when CO2 levels are high (hypercapnia), there is ____ventilation and an ____ environment

Answer 71

hyperventilation acidic

Question 72

what mm Hg of PaO2 is considered hypoxemia?

Answer 72

<80 mm (note: COPD pts may be asymptomatic at <50)

Question 73

how will the body compensate with high bicarbonate levels?

Answer 73

produce ketones

Question 74

a right shift of the oxygen saturation curve indicates ___ SpO2 and more blood in the ____

Answer 74

low plasma

Question 75

during hypoventilation, CO2 is ____ and the environment is ____

Answer 75

increased acidic

Question 76

during hyperventilation, CO2 is ____ and the environment is ____

Answer 76

decreased basic

Question 77

what type of ventilation is seen during ketoacidosis?

Answer 77

hyperventilation

Question 77

how long does it take the metabolic system to to control acid/base balance?

Answer 77

days

Question 78

how long does it take the respiratory system to to control acid/base balance?

Answer 78

quick - minutes

Question 79

what controls the acid/base balance in the metabolic system?

Answer 79

kidneys retain or release bicarbonate

Question 80

components of vital capacity

Answer 80

tidal volume + inspiratory reserve volume + expiratory reserve volume

Question 81

functional residual capacity components

Answer 81

expiratory reserve volume + residual volume